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What do we know about pain?  What do we know about the connection between physical and emotional pain responses in the body and brain?

It took me many months of online research before I finally came up with what links our physical and emotional pain responses (and our pain thresholds) together.  I found it in

SUBSTANCE P — a small peptide (protein) released upon stimulation in the nervous system and involved in regulation of the pain threshold.  Substance P (P = pain) works the same in our body whether we have a broken bone or a broken heart.

I’m not sure it helps when we HURT from any pain to say to ourselves, “Oh, that pain is just me feeling Substance P.”  But it might help to realize more clearly that there is a direct and definable link between our ability to experience emotional and/or physical pain in our body-brain.  Emotional distress, including sadness, loneliness and anxiety,  is as real a pain in our body as is any physical pain we can ever experience.

And when terrible physical and emotional pain was forced upon us from early child abuse and neglect experiences, I believe the entire balance of how all these complex pain response systems in our body is altered for the rest of our lifetime.

And I also find it fascinating that Substance P is connected to our ‘puke center’.  In our early evolving brain-mind, what was toxic needed to be vomited out ASAP for our continued survival.  As we became increasingly complex beings, we eventually could not puke out mental, emotional and psychological toxins, poisons and traumas.  We had to find ways to endure in spite of them.

(Epigenetic changes are one of the ways we do this – see yesterday’s post.  These changes have a lot to do with where so-called ‘mental illness’ comes from.)

Substance P is connected to our immune system.  That doesn’t surprise me one single bit.  It is intimately involved with maintenance of our well-being – including the healing of all of our wounds.  Once we truly accept the fact that emotional wounds ARE physical wounds, I believe we can better get on with the business of healing.

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Substance P has effects on mood, memory and sleep, and has been implicated in posttraumatic stress disorder (PTSD).

It is involved with depression and the actions of antidepressant drugs.

Substance P is involved with sadness.

Substance P is also involved with anxiety and stress responses and disorders.

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FULL ARTICLE (abstract below) CAN BE PURCHASED ONLINE OR ORDERED IN FROM A LIBRARY:

Psychol Bull. 2007 Nov;133(6):1007-37

Substance P at the nexus of mind and body in chronic inflammation and affective disorders.

Rosenkranz MA.

Department of Psychology, University of Wisconsin-Madison, WI 53705, USA. marosenk@wisc.edu

For decades, research has demonstrated that chronic diseases characterized by dysregulation of inflammation are particularly susceptible to exacerbation by stress and emotion. Likewise, rates of depression and anxiety are overrepresented in individuals suffering from chronic inflammatory disease. In recent years, substance P has been implicated in both the pathophysiology of inflammatory disease and the pathophysiology of depression and anxiety by 2 parallel fields of study.

This review integrates the literature from these 2 parallel fields and examines the possibility that substance P dysregulation may be a point of convergence underlying the overlap of chronic inflammatory disease and mood and anxiety disorders.

First, the involvement of substance P in peripheral inflammation and in the immune events associated with chronic inflammatory disease is discussed, with a focus on inflammatory bowel disease and asthma.

Next, the function of substance P in the communication of peripheral inflammation to the brain is considered.

Finally, to complete the bidirectional loop of brain-immune interactions, substance P expression in anxiety and depression as well as its potential role in the neural regulation of peripheral inflammation is reviewed.

PMID: 17967092 [PubMed – indexed for MEDLINE]

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From Wickipedia:

In the field of neuroscience, substance P (SP) is a neuropeptide….that functions as a neurotransmitter and as a neuromodulator.^[1][2] It belongs to the tachykinin neuropeptide family. Substance P and its closely related neuropeptide neurokinin A (NKA) ….Substance P is released from the terminals of specific sensory nerves, it is found in the brain and spinal cord, and is associated with inflammatory processes and pain.

Function

Substance P is an important element in pain perception. The sensory function of substance P is thought to be related to the transmission of pain information into the central nervous system. Substance P coexists with the excitatory neurotransmitter glutamate in primary afferents that respond to painful stimulation.^[11] SP has been associated with the regulation of mood disorders, anxiety, stress,^[12] reinforcement,^[13] neurogenesis,^[14] respiratory rhythm,^[15] neurotoxicity, nausea/emesis,^[16] pain and nociception.^[17] Substance P and other sensory neuropeptides can be released from the peripheral terminals of sensory nerve fibers in the skin, muscle and joints. It is proposed that this release is involved in neurogenic inflammation which is a local inflammatory response to certain types of infection or injury.^[18] …. Substance P receptor antagonists may have important therapeutic applications in the treatment of a variety of stress-related illnesses, in addition to their potential as analgesics.

Vomiting

The vomiting center in the brainstem contains high concentrations of substance P and its receptor, in addition to other neurotransmitters such as choline, histamine, dopamine, serotonin, and opioids. Their activation stimulates the vomiting reflex. Different emetic pathways exist, and substance P/NK1R appears to be within the final common pathway to regulate vomiting.^[19] Substance P antagonist (SPA) aprepitant is available in the market in the treatment of chemotherapy-induced nausea / emesis.

Pain

Substance P is involved in nociception, transmitting information about tissue damage from peripheral receptors to the central nervous system to be converted to the sensation of pain. It has been theorized that it plays a part in fibromyalgia.

Cell growth

Substance P has been known to stimulate cell growth in culture,^[20] and it was shown that Substance P could promote wound healing of non-healing ulcers in humans.^[21] It has also been shown to reverse diabetes in mice.^[22][23]

Vasodilation

Substance P also has effects as a potent vasodilator. ….As is typical with many vasodilators, it also has bronchoconstrictive properties, administered through the non-adrenergic, non-cholinergic nervous system (branch of the vagal system)

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